Intranasal Mometasone After External Dacryocystorhinostomy—Necessity or Convention? A Retrospective Two-Centre Cohort Study
4 affiliations
- 1Department of Ophthalmology, Fundación Oftalmológica Médica de la Comunidad Valenciana (FOM), 46015 Valencia, Spain
- 2Department of Oculoplastics, Clínica Baviera, 46005 Valencia, Spain
- 3Surgery Department, Ophthalmology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
- 4Spanish Network of Inflammatory Diseases: REI-RICORS (RD24/0007/0004) of the Institute of Health Carlos III (ISCIII), Spanish Government, 28029 Madrid, Spain
Abstract
Background/Objectives: Intranasal corticosteroids are frequently prescribed after dacryocystorhinostomy (DCR) to modulate mucosal healing and prevent ostium closure, but evidence supporting their use after external DCR (EXT-DCR) is scarce. This study compared early anatomical success after EXT-DCR under two centre-specific postoperative protocols that differed in the use of intranasal mometasone. Methods: Retrospective comparative cohort study of 243 consecutive EXT-DCR procedures (211 patients) for distal lacrimal obstruction performed by a single surgeon using the same technique at two centres between 2019 and 2025. Postoperative treatment was determined by each centre’s standing protocol: both included oral amoxicillin–clavulanic acid for one week, and one centre additionally prescribed intranasal mometasone furoate twice daily for two months (mometasone group, n = 64; control group, n = 179). The primary outcome was anatomical success, defined as lacrimal patency on irrigation at two months. Groups were compared with Fisher’s exact test and a multivariable logistic regression adjusted for age and sex. Results: Anatomical success was 93.8% (60/64) in the mometasone group and 89.9% (161/179) in the control group (absolute difference 3.8 percentage points; 95% CI −5.7 to 10.3; p = 0.45). After adjustment for age and sex, treatment group was not significantly associated with success (control vs. mometasone: OR 0.57; 95% CI 0.18–1.77; p = 0.33). No statistically significant associations were detected for age or sex. Conclusions: In this cohort, adding a two-month course of intranasal mometasone to standard postoperative care after EXT-DCR was not associated with a statistically significant improvement in early anatomical success. Given the limited statistical power and a confidence interval that does not exclude a clinically meaningful benefit, this absence of a significant difference does not establish therapeutic equivalence. Adequately powered prospective trials with longer follow-up are needed before routine intranasal corticosteroid use after EXT-DCR can be either recommended or abandoned.
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BibTeX
@article{ortegaevangelio2026intranasal,
title = {{Intranasal Mometasone After External Dacryocystorhinostomy—Necessity or Convention? A Retrospective Two-Centre Cohort Study}},
author = {Leticia Ortega-Evangelio and Gonzalo Roig-Ferreruela and Cristina Peris-Martínez},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218505},
url = {https://www.mdpi.com/2077-0383/15/21/8505},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Intranasal Mometasone After External Dacryocystorhinostomy—Necessity or Convention? A Retrospective Two-Centre Cohort Study
AU - Leticia Ortega-Evangelio
AU - Gonzalo Roig-Ferreruela
AU - Cristina Peris-Martínez
PY - 2026
DA - 2026/11/02
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218505
UR - https://www.mdpi.com/2077-0383/15/21/8505
AB - Background/Objectives: Intranasal corticosteroids are frequently prescribed after dacryocystorhinostomy (DCR) to modulate mucosal healing and prevent ostium closure, but evidence supporting their use after external DCR (EXT-DCR) is scarce. This study compared early anatomical success after EXT-DCR under two centre-specific postoperative protocols that differed in the use of intranasal mometasone. Methods: Retrospective comparative cohort study of 243 consecutive EXT-DCR procedures (211 patients) for distal lacrimal obstruction performed by a single surgeon using the same technique at two centres between 2019 and 2025. Postoperative treatment was determined by each centre’s standing protocol: both included oral amoxicillin–clavulanic acid for one week, and one centre additionally prescribed intranasal mometasone furoate twice daily for two months (mometasone group, n = 64; control group, n = 179). The primary outcome was anatomical success, defined as lacrimal patency on irrigation at two months. Groups were compared with Fisher’s exact test and a multivariable logistic regression adjusted for age and sex. Results: Anatomical success was 93.8% (60/64) in the mometasone group and 89.9% (161/179) in the control group (absolute difference 3.8 percentage points; 95% CI −5.7 to 10.3; p = 0.45). After adjustment for age and sex, treatment group was not significantly associated with success (control vs. mometasone: OR 0.57; 95% CI 0.18–1.77; p = 0.33). No statistically significant associations were detected for age or sex. Conclusions: In this cohort, adding a two-month course of intranasal mometasone to standard postoperative care after EXT-DCR was not associated with a statistically significant improvement in early anatomical success. Given the limited statistical power and a confidence interval that does not exclude a clinically meaningful benefit, this absence of a significant difference does not establish therapeutic equivalence. Adequately powered prospective trials with longer follow-up are needed before routine intranasal corticosteroid use after EXT-DCR can be either recommended or abandoned.
SN - 2077-0383
ER -